TWO new studies published today in JAMA Neurology have confirmed previous observations that glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) reduce the risk of Alzheimer's and related dementias in people with type 2 diabetes.
One study used electronic health record data from almost 100,000 people to compare GLP-1RAs, which include semaglutide and dulaglutide, SGLT2is, such as dapagliflozin and empagliflozin, and other glucose-lowering drugs.
GLP-1RAs and SGLT2is both reduced the risk of dementias relative to other glucose-lowering drugs over a follow-up period of up to four years.
The other study was a systematic review and meta-analysis of 26 randomised clinical trials including around 165,000 patients.
It found that GLP-1RAs were associated with a statistically significant reduction in dementia or cognitive impairment, but not SGLT2is.
While the mechanism for dementia prevention is not known at this stage, both classes of drugs have been demonstrated to reduce the inflammation (a key driver of Alzheimer's disease) and reduce vascular risk (a key driver of vascular dementia) more than would be expected by the sugar control alone.
Experts recommended caution in interpreting the study results, pending ongoing randomised trials in this area.
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